Current jobs related to Risk Adjustment Coder - Hialeah FL United States - Centene
-
Actuarial Director, Risk Adjustment
2 months ago
United States of America Selby Jennings Full timeA leading health plan in the Midwest is looking for a seasoned ASA/FSA to lead its Risk Adjustment & Quality Analytics team!This position can be worked remotely from anywhere in the U.S. (with 5-10% annual travel to HQ)ResponsibilitiesConducts risk score calculations and forecasts for all lines of businessAssesses the financial implications of potential...
-
Actuarial Director, Risk Adjustment
1 month ago
United States of America Selby Jennings Full timeA leading health plan in the Midwest is looking for a seasoned ASA/FSA to lead its Risk Adjustment & Quality Analytics teamThis position can be worked remotely from anywhere in the U.S. (with 5-10% annual travel to HQ)ResponsibilitiesConducts risk score calculations and forecasts for all lines of businessAssesses the financial implications of potential...
-
Certified Medical Coder
2 months ago
Sierra Vista, AZ, United States Northeast Healthcare Recruitment, Inc. Full timeWe are seeking a meticulous anddetail-oriented Certified Medical Coder to join our team in Sierra Vista, AZ.The primary responsibility of this role is to review and ensure the accuracy ofmedical coding for all services rendered by assigned providers. This includesensuring appropriate diagnostic documentation of risk and chronic conditionsthrough a master...
-
Risk Adjustment Coding and Chart Coordinator
1 week ago
Albany, NY, United States CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC Full timeGrounded by a compelling mission, core values, and compassion for people, CDPHP and its family of companies offer a strong foundation for a rewarding career. Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The...
-
Medical Claims Adjuster
2 weeks ago
Tampa, FL, United States USAA Full timeWhy USAA?At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all of our employees served in our nation’s military, but we all share in the mission to give back to those who did. This hybrid role requires an individual to be in the office 3 days per week. Relocation...
-
Sr. Product Manager, Risk Adjustment and Quality
4 weeks ago
Hopkins, MN, United States Optum Full timeOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...
-
Office Adjuster
2 weeks ago
Tampa, FL, United States USAA Full timeWhy USAA?At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all of our employees served in our nation’s military, but we all share in the mission to give back to those who did. This hybrid role requires an individual to be in the office 3 days per week. Relocation...
-
Office Adjuster
2 weeks ago
Tampa, FL, United States USAA Full timeWhy USAA?At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all of our employees served in our nation’s military, but we all share in the mission to give back to those who did. This hybrid role requires an individual to be in the office 3 days per week. Relocation...
-
Set-Up Mechanic
3 months ago
Hialeah, United States Prime Matter Labs Full timeJob DescriptionJob DescriptionSet-Up MechanicType: Full-timeLocation: Miami, FloridaWho we are: We’re Prime Enterprises, a personal care product manufacturer with 40 years of experience formulating, compounding, and filling products for some of the most successful and respected brands in the world. We exist to bring better products to the world by...
-
Certified Coder
1 week ago
Sandusky, OH, United States NOMS Healthcare Full timeJob Summary:A coder assists the Central Billing Office with analysis and review of various medical coding activities of NOMS Healthcare. This job includes collaborating with providers on coding decisions and other relevant point of service coding and documentation questions and inquiries. This job also includes conducting routine internal medical record...
-
Trainer-Auditor (Clinical)
4 weeks ago
HIALEAH, United States Centene Full timeYou could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for developing and conducting a variety...
-
Nurse Practitioner NP, Part-Time, HRA
7 days ago
Twin Falls, ID, United States Hueman Risk Adjustment Solutions Full timeHueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Twin Falls, ID.This unique opportunity adapts to your lifestyle, giving you the freedom to achieve your professional goals on your terms, all while enjoying a schedule designed with your preferences in mind. Whether...
-
Registered Nurse
6 days ago
New York, NY, United States The Riverside Premier Rehabilitation and Healing Center Full timeRegistered Nurse (RN) Risk ManagerThe Riverside Premier Rehabilitation and Healing Center is looking for a talented and hardworking Registered Nurse (RN) Risk Manager to join our ever-growing team.Registered Nurse (RN) Risk Manager Job Description:Ensure compliance with elements of FS 400.147Coordinate data gathering functions of risk management as well as...
-
Summer Associate Internship
7 days ago
Pensacola, FL, United States Navy Federal Credit Union Full timeOverviewTeam Overview: At Navy Federal, member-centricity is our strategic foundation and we have invested to build enterprise capabilities that enable current and future member financial well-being and team member success through innovative, human centered, and data driven Digital experiences.Navy Federal's Digital department is responsible for delivering...
-
Summer Associate Internship
9 hours ago
Pensacola, FL, United States Navy Federal Credit Union Full timeOverviewTeam Overview: At Navy Federal, member-centricity is our strategic foundation and we have invested to build enterprise capabilities that enable current and future member financial well-being and team member success through innovative, human centered, and data driven Digital experiences.Navy Federal's Digital department is responsible for delivering...
-
Senior Clinical Coding Nurse Consultant
1 day ago
Pflugerville, TX, United States Optum Full time$5000. Sign on Bonus Available for External Candidates Incentive Bonus Annually 23 days of PTO & Closed on Major Holidays 401K Match This position is located in Austin, Texas and is NOT a Remote position For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the...
-
Risk Management Specialist
1 week ago
Vienna, VA, United States TEKsystems Full timeThis Risk Management Specialist role is on a flexible HYBRID schedule, requiring that the candidate can commute to a Vienna VA office location.Description:• Identify patterns of activity indicating possible fraud or account abuse• Monitor account transactions to proactively identify fraudulent activity, suspicious communications, take immediate...
-
McAllen, TX, United States Optum Full timeWellMed, part of the Optum family of businesses, is seeking a Registered Nurse RN Senior Clinical Coding Nurse to join our team in Mcallen, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for...
-
New Braunfels, TX, United States Optum Full timeOpportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you...
-
Senior Clinical Coding Nurse Consultant
3 weeks ago
Round Rock, TX, United States Optum Full time$5000. Sign on Bonus Available for External Candidates Incentive Bonus Annually 23 days of PTO & Closed on Major Holidays 401K Match For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing...
Risk Adjustment Coder
1 month ago
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: The Coder will work daily reviewing medical records abstracting any HCCs that are able to be validated. Coders will also work additional special projects as needed.
- Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Ninth Revision (ICD-10). Always coding to the highest level of specificity.
- Follows the Official ICD-10 guidelines for Coding and Reporting and has a complete understanding of these guidelines.
- Follows CMS risk adjustment guidelines and has a complete understanding of these guidelines.
- Understands the impact of ICD-10 codes on the CMS HCC risk adjustment model.
- Ability to meet productivity and accuracy standards
- Ability to defend coding decisions to both internal and external audits.
- Performs other duties as assigned.
- Complies with all policies and standards
Required Education: High School or GED
Preferred: Bachelor's Degree in a related field
Required Experience: 2+ years of experience in professional coding experience either in a hospital or physician setting
Licenses and Certifications:
A license in one of the following is required:
Required Certified Professional Coder (CPC)
Preferred Certified Coding Specialist (CCS)
Preferred Skills:
Experience with Risk Adjustment coding
Comfortable utilizing Microsoft 365 (Word, Excel, Teams, Outlook)
Ability to navigate through the ICD-10-CM codebook without the assistance of an encoder
Pay Range: $22.36 - $38.07 per hourCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.